无限制饮食在HSCT后的中性质衰竭期间不会增加感染:来自多中心随机试验的数据
Federico Stella1, Vincenzo Marasco2, Giorgia Virginia Levati2
1Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Blood advances
|July 14, 2023
概括
无限制性饮食 (NRD) 与保护性饮食 (PD) 在预防血造干细胞移植 (HSCT) 后中性质衰竭期间的感染方面同样有效. NRD提高了患者的满意度,而不会影响安全性或结果.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 营养科学 营养科学
背景情况:
- 感染是中性衰竭患者在血造细胞干细胞移植 (HSCT) 后发病和死亡的重要原因.
- 低微生物保护性饮食 (PD) 是标准的护理,但其潜在的有效性尚未得到证实.
研究的目的:
- 为了比较非限制性饮食 (NRD) 与保护性饮食 (PD) 的疗效和安全性,在接受HSCT或高剂量化疗的患者中.
- 评估饮食对感染率,死亡率和患者报告结果的影响.
主要方法:
- 一个多中心的,随机的,非劣等性试验.
- 222名接受高剂量诱导化疗或HSCT的成年患者被随机分配到NRD或PD.
- 结果包括感染的发生率,中性质衰竭期间的死亡率,住院时间和患者满意度.
主要成果:
- 在NRD和PD组之间,在NRD和PD组之间,在2级以上的感染或中性衰竭期间的死亡没有显著差异.
- 多变量分析确定了多发性骨髓瘤,诺基诺预防和缺少粘膜炎作为降低感染风险的因素.
- NRD与患者报告的满意度更高有关,住院,粘膜炎,胃肠道感染或营养标志物没有显著变化.
结论:
- 一种无限制的饮食不低于一个保护性饮食的中性衰竭患者后HSCT.
- 限制性饮食可能会不必要地负担患者的生活质量,而不会改善临床结果.
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